運用羅氏適應模式照護一位第一型糖尿病青少年之護理經驗

A Nursing Experience of Applying Roy's Adaptation Model to Care An Adolescent with Type 1 Diabetes

本文旨在運用羅氏適應模式協助一位第一型糖尿病青少年之護理經驗，青春期的個案與家屬對飲食控制和胰島素注射劑量錯誤，有高低血糖合併症的風險，個案因糖尿病治療造成自我身體概念和學校生活的影響引發筆者探討的動機。護理期間自2019年6月25日至7月3日，運用羅氏適應模式為評估基礎收集資料，確立個案健康問題有潛在危險性不穩定血糖濃度、身體心像紊亂、家庭因應失能。護理過程中結合醫師、營養師等照護團隊，傾聽個案與家屬對血糖值的擔憂感受，於家庭會議澄清誤解的管理知識，共同擬訂照護計畫；與個案建立良好人際關係，配合個案青春期發展特性，提供糖尿病照護資訊與自我成長書籍等，強化個案的自主管理信心，並藉由與學校導師的衛教宣導及協助參加病友會等社會支持系統，幫助個案校園適應，維持家庭功能運作，讓個案回歸正常化生活。建議護理人員在照護青春期糖尿病病童時，應強化個案對疾病自主管理的重要性，促進如胰島素注射劑量計算等照護的自主管理能力，於家庭及社會支持下達到以家庭為中心的護理理念。

This article presents a case report of nursing experience using Roy's Adaptation Model to care for an adolescent with type 1 diabetes. Due to errors in diet control and insulin injection doses by the adolescent and their family members, the patient was at risk of high and low blood sugar complications, affecting their self-body concept and school life. From June 25 to July 3, 2019, the author used Roy's Adaptation Model assessments to evaluate the adolescent's health problems, including the potential risk of unbalanced blood glucose, physical and mental disorder, and dysfunctional family-related coping strategies. To address these issues, a multidisciplinary team, including physicians and nutritionists, was formed to educate the patient and their family on proper diabetes management, develop care plans tailored to the adolescent's developmental needs, and provide health education advocacy to school tutors. The goal was to empower the patient with self-management confidence, adapt to school life, maintain a functional family dynamic, and guide them back to a normal life, highlighting the importance of individualized care, family-centered nursing, and social support in achieving optimal outcomes for adolescent diabetic patients.